Vertebral Body and Spinal Compression Fractures

Vertebra or spinal bone
Vertebra or spinal bone. MedicalRF.com/Getty Images

For people with osteoporosis or osteopenia, getting older isn't easy. These related disorders, which are characterized by thinning and weakened bones, often lead to vertebral compression fractures — or put more simply, bone breaks in spinal vertebrae.

In fact, the International Osteoporosis Foundation says that osteoporosis causes one fracture (of any type) every 3 seconds.

Who is most affected by fracture risk related to posed by osteoporosis or osteopenia?

Mostly it's senior and elderly women (although men are at risk, as well.) A 2012 study published by the Permanente Journal found that about 25% of all postmenopausal women experience a spinal fracture some time during their lives.  

If you're a woman over the age of 50 and you live with either disease, you have an approximately 1 in 3 chance of sustaining a spinal fracture, according to the International Foundation of Osteoporosis. Plus, you're more likely to fracture again in the future.

Along with back pain (both short term flare ups and long term discomfort) a vertebral fracture may result in spinal deformity, disability or decreased ability to carry out your daily activities, diminished quality of life and higher medical costs. 

A meta-analysis protocol, published in 2017, reports that vertebral fractures tend to occur following a collapse of the front of the spinal column. 

Vertebral Compression Fractures

Vertebral compression fractures generally occur when the front part of the spinal bone (called the vertebral body and discussed in more detail below) —for whatever reason — cannot support the load of the spine.

While age-related osteoporosis or osteopenia often play big roles in the onset of a spinal fracture (especially when considering the number of cases in the population as a whole) other causes do exist. These can include injury to the spine, plus diseases that compromise bone (for example, cancer or infection.)

Symptoms of a spinal compression fracture include severe, acute back pain that gets better when you rest. The area near the injury may be tender to the touch, as well. You might also experience radiculopathy, or nerve related sensations (plus pain, of course) that go down one leg or arm, although this set of symptoms is rare in cases of spinal fracture. Pain may occur when you bend or twist your spine.

Compression fractures often result in a loss of vertebral height, and restoring that height is the goal of surgeries commonly done for this injury. The loss of height is generally due to the restructuring of the front of the spinal bone, i.e., the vertebral body, in to a wedge shape, which tends to happen as a result of the collapse. (The bony ring that is attached to the back of the vertebral body remains largely unphased, though.) 

Understand the Vertebral Body

As mentioned above, spinal compression fractures mainly affect the vertebral body. The vertebral body is the largest part of the spinal bone, and it comprises the anterior portion of the vertebra, meaning it is located in front, relative to the bony ring that is attached to it.  From a side view, the front of the vertebral body is closer to the front of your body, while the bony ring is closer to the back.

The vertebral body is generally shaped like a short cylinder. In normal, uninjured spinal bones, this cylindrical shape varies a bit, depending upon whether it's located in the cervical (neck) thoracic (mid and/or upper back) or lumbar areas of the spine. (The same is also true of the other parts of the vertebra; for example, the spinous processes on the back of cervical vertebrae are more elongated than those of the lumbar spine.)

The vertebral bodies in the lumbar spine are thicker, stronger and built more upright than are the thoracic and cervical vertebrae. This is likely related to the extra weight bearing required of lumbar vertebrae as compared to the thoracic and cervical, which are located above them.

 

The vertebral bodies of the spine stack up on one another to create the vertebral column. The vertebral bodies help provide important support for sitting, standing, walking and other movements. Between the vertebral bodies are the intervertebral discs, providing cushioning and shock absorption.

The vertebral bodies also provide (in combination with other parts of the vertebra) the boundaries for the spaces through which the spinal cord travels, as well as branching nerves that exit the spine on their way to all parts of the body.

Treatments for Vertebral Compression Fractures

Treatmens for broken spinal bones include surgery and conservative care. The two most commonly given surgeries are balloon kyphoplasty and percutaneous vertebroplasty. Both procedures attempt to restore lost height to the collapsed bone. Conservative, aka non-surgical care, may consist of bed rest, medication, wearing a back brace and/or physical therapy. If you go the conservative route, know that strengthening your spine will be an important part of your therapy.

 

 

Source:

Alexandru, D. M.D., So, W. M.D. Evaluation and Management of Vertebral Compression Fractures Perm J. 2012 Fall; 16(4): 46–51.

Kan, S., Yuan, Z., Chen, L., Sun, J., Ning, G., Feng, S. Which is better for osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty or non-surgical treatment? A study protocol for a Bayesian network meta-analysis. Jan. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253565/

Women over 50 will experience osteoporotic Fractures, as will men. Facts and statistics. International Osteoporosis Foundation website. https://www.iofbonehealth.org/facts-statistics

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